Mon.May 13, 2024

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RAND: Hospitals charged insurers 254% more than Medicare rates in 2022

Fierce Healthcare

The gap between insurance plans and Medicare's payments to hospitals for inpatient and outpatient services widened over the course of just a couple of years, a new study from RAND Corporation | A new report from RAND Corporation highlighted just how much more employers and private insurers are paying hospitals for inpatient and outpatient services.

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AHA, H-ISAC warn hospitals about Black Basta following Ascension cyberattack

Healthcare It News

The Health Information Sharing and Analysis Center issued a threat alert Friday about the Russia-backed ransomware group Black Basta, warning of its accelerated attempted attacks against the healthcare sector. Prompted by H-ISAC, the American Hospital Association also sent a cybersecurity advisory with technical mitigation recommendations to its members.

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Medicare Advantage unrest, Change Healthcare fallout and more big takeaways from insurers’ Q1

Health Care Dive

All major payers saw elevated utilization but only an unprepared few struggled with the trend, the Change Healthcare cyberattack caused minimal financial fallout and a new D-SNP rule opens the door to a Medicare growth opportunity.

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Talkspace expands online mental health therapy to millions of Medicare members

Fierce Healthcare

Online therapy provider Talkspace is making a big push into the Medicare market, rolling out to approximately 13 million members in 11 states. | Talkspace plans to expand to all 33 million traditional Medicare members, coupled with several Medicare Advantage plans, across all 50 states by the end of the year.

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From Diagnosis to Delivery: How AI is Revolutionizing the Patient Experience

Speaker: Simran Kaur, Founder & CEO at Tattva Health Inc.

The healthcare landscape is being revolutionized by AI and cutting-edge digital technologies, reshaping how patients receive care and interact with providers. In this webinar led by Simran Kaur, we will explore how AI-driven solutions are enhancing patient communication, improving care quality, and empowering preventive and predictive medicine. You'll also learn how AI is streamlining healthcare processes, helping providers offer more efficient, personalized care and enabling faster, data-driven

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America’s healthcare networks are under attack

Health Care Dive

The stakes, impact and cost of cybercrime is rising and we must employ the right tech to fight back.

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Evernorth: How employers can take the lead on addressing youth mental health

Fierce Healthcare

Mental health concerns among youth continue to rise, and employers can play a significant role in mitigating these challenges, according to a new study from Cigna's Evernorth division. | Mental health concerns among youth continue to rise, and employers can play a significant role in mitigating these challenges, according to a new study from Cigna's Evernorth division.

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Kaiser Permanente posts 3.4% operating margin, billions in net income for Q1 2024

Fierce Healthcare

Kaiser Permanente kicked off 2024 with $935 million of operating income (3.4% operating margin) and more than $2.7 billion of net income when excluding a one-time, $4.6 billion net asset gain from | The integrated nonprofit's operations more than quadrupled the return of last year's first quarter, though the organization said its performance still lags pre-pandemic numbers.

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Trends in telehealth: Integrating physicians into virtual care

Health Care Dive

Many physicians are interested in working in telehealth, whether it’s part-time, full-time or gig work. Here are the factors to consider when integrating physicians into a virtual care program.

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Investors 'cautiously optimistic' about the state of the digital health market

Fierce Healthcare

At the American Telemedicine Association’s Nexus conference in Phoenix, three investors talked digital health investing trends they’ve observed so far this year. | While 2023 was a tough year for digital health investment, three investors discussed the investment trends they're seeing this year and the state of artificial intelligence.

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Dealing with Angry People

Pro CRNA

By Thomas Davis, DNAP, MAE, CRNA A surgical technician came into the locker room at our outpatient center with out-of-control anger shouting, “They have idiots running this place and I’m not going to take it any longer.” He changed clothes, walked out the door and never returned…road rage on steroids. Anger in the workplace is something that we have all witnessed during our career.

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How to Make The Best Benefits Decisions for 2025's Workforce: An HR and Total Rewards Guide

Speaker: Kaitlin Ruby Carroll

Retaining top talent in 2025 means rethinking benefits. In a competitive job market, fertility benefits are more than just offerings - they are a commitment to your team’s well-being. Gain critical insights into the latest fertility benefits strategies that can help position your organization as an industry leader. Our expert will explore the unique advantages and challenges of each model, share success stories from top organizations, and offer practical strategies to make benefits decisions tha

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Fierce Healthcare Fundraising Tracker—Lore banks $80M to tackle loneliness; Clinical AI startup SmarterDx snags $50M

Fierce Healthcare

At Fierce Healthcare, we keep track of all the venture capital being funneled into the health tech and digital health industries. | Lore Health uses AI technology paired with a first-of-its-kind social network to promote healthy lifestyles and combat isolation. The startup picked up $80 million in fresh funding. Check out that fundraising deal along with other recent venture capital funding rounds.

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Promoting HIPAA Compliance in Healthcare Organizations

p3care

HIPAA (Health Insurance Portability and Accountability Act) is concerned with securing patients’ data. It incorporates strict rules and regulations for healthcare data pertaining to patients’ information. Also, The primary objective of this compliance is to keep reports confidential and secure. It’s a mandatory act if healthcare providers and related stakeholders want to proceed without any restriction.

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UPMC pays $38M to settle 12-year-old whistleblower case

Fierce Healthcare

UPMC is putting a 12-year-old False Claims Act suit to bed with a $38 million settlement payment. | Plaintiffs had alleged that the nonprofit system was overcompensating neurosurgeons to refer patients to its facilities for procedures. A spokesperson for UPC said the organization was "pleased" to resolve the case believed to be one of the highest payouts for a False Claims case not taken up by the government.

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Using AI to address 5 critical business challenges in healthcare

Health Care Dive

AI transforms healthcare: Tackle patient expectations, debt crisis, regulatory hurdles and staffing shortages.

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Why Every Small Business Needs an HCM Solution: A Comprehensive Guide

Managing HR tasks like payroll, compliance, and employee data can overwhelm small businesses. That’s where a Human Capital Management (HCM) solution comes in. Our eBook, Why Every Small Business Needs an HCM Solution: A Comprehensive Guide , shows how an HCM system automates tedious processes, ensuring your business stays compliant and efficient. You’ll learn how to simplify payroll, eliminate costly errors, and empower your employees with self-service tools.

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Survey: Here’s how the legal landscape for telehealth insurance coverage has changed since 2019

Fierce Healthcare

Popular digital health law firm Foley & Lardner releas | Law firm Foley & Lardner released a new 50-state survey that compares telehealth laws from 2019 to 2024. While more states have moved towards payment parity for telehealth, remote monitoring lacks coverage requirements in half of states.

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Black Basta ransomware is toying with critical infrastructure providers, authorities say

Health Care Dive

The threat group has impacted more than 500 targets worldwide, including those in healthcare.

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CMS Guidance on IRA Price Negotiation: Part 3

Healthcare ECONOMIST

See my previous posts on IRA price negotiation on drug selection ( Part 1 ) and manufacturer data submission ( Part 2 ). Today we will talk about the negotiation process and how CMS will set the maximum fair price (MFP) How will CMS price across dosages? “CMS will base the single price on the cost of the selected drug per 30-day equivalent supply (rather than per unit—such as tablet, capsule, injection—or per volume or weight-based metric), weighted across dosage forms and strengths.

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Emerging Threats to Financial Markets

The Rand Blog

The greatest danger to the U.S. financial system is the constant assault on reality—the deepfake videos and manipulated AI—that could weaken the system over time. It will be slow, but it will be steady and hard to stop—more like financial climate change.

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Best Practices to Streamline Compensation Management: A Foundation for Growth

Speaker: Joe Sharpe and James Carlson

Payroll optimization can be one of the most time-consuming and complex factors of small business management. Yet, organizations that crack the code on streamlining employee compensation often discover innovative avenues for growth. With the right strategies in place, outsourcing and streamlining payroll processes can result in substantial time and resource savings.

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Revenue Integrity in 2024: Reducing Leakage Points in a Complicated Cycle

HIT Consultant

Tanya Sanderson, RN, BSN, MBA, MHA, CLNC, CHFP, Sr. Director of Revenue Integrity, Xsolis The concept of “revenue integrity” hasn’t really changed over the years, but the roles, responsibilities, and oversight have become far more complex and difficult to gain industry consensus around. What began as several defined systems of controls by which hospitals guarded against revenue loss, revenue integrity has seemingly turned into more narrowly focused controls in many organizations, leaving critica

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Home-Based Care Investors Show Interest, But M&A Pace Remains Cautious

Home Health Care

Home-based care dealmakers have been busier of late, but that has not yet translated into more transactions. There’s some feeling that sidelined private equity firms will eventually have to enter the game, but that may not be the case. For one, interest rates have still not come down. But also, the “dry powder effect” – and available money being ready to be deployed by PE firms – can sometimes be overstated, Rebecca Springer, the lead health care analyst at Pitchbook, told Home Health Care News.

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Curbside Consult with Dr. Jayne 5/13/24

HIStalk

I have friends who work for Ascension. The concerns coming.

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PE Sponsors Of Comfort Keepers, New Day Healthcare Are In Home-Based Care For The Long Haul

Home Health Care

While some private equity investors have been sidelined by macro and micro headwinds, there are still plenty of PE firms invested in home-based care that like where they are. On the Medicare-certified home health side, one factor that may have made investors hesitant to enter the space is the challenging payment landscape. Despite this, Kaltroco — a family-owned private investment company — is attracted to home health care due to the firm’s belief in the fundamentals of the sector.

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How To Empower Your Workforce With Modern Fertility Benefits

Speaker: Andrea Wuchiski

In an era where a workforce spans multiple generations, HR managers and Total Rewards leaders face the unique challenge of designing benefits packages that cater to diverse employee needs. This session will delve into how comprehensive fertility benefits can bridge generational gaps, support employees’ health, and enhance workplace satisfaction. Join us for an insightful session that highlights the strategic importance of fertility benefits in today’s competitive job market.

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HHS Announces Funding Opportunity to Improve AI-Powered Healthcare & Behavioral Health IT

HIT Consultant

What You Should Know: – The U.S. Department of Health and Human Services (HHS) , through the Office of the National Coordinator for Health Information Technology (ONC), is seeking innovative solutions to advance healthcare through artificial intelligence (AI) and improve health IT adoption in behavioral health settings. – This initiative is driven by the Leading Edge Acceleration Projects (LEAP) in Health Information Technology (Health IT) funding opportunity for fiscal year 2024.

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Jim Rechtin To Take Over For Bruce Broussard As Humana CEO This Summer

Home Health Care

Jim Rechtin, who was named Bruce Broussard’s successor at Humana Inc. (NYSE: HUM) in October of last year , will officially take over on July 1, the company announced Monday. Rechtin joined Humana as president and COO in January, and will also join the board of directors on July 1 when he transitions to CEO. “I am incredibly excited to be named CEO of Humana and humbled to have the opportunity to lead 65,000 dedicated teammates as we seek to provide better health outcomes at lower costs for our

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Building more effective health systems through social determinants and patient-centered approaches

Nordic

The healthcare landscape is undergoing a significant shift. As we move toward a value-based model , the focus is intensifying on patient-centered care , with improved outcomes and population health taking center stage. To fully deliver safe, effective, timely, efficient, and equitable care that enables people to take responsibility for their health and well-being, we must tackle health disparities and inequities tied to social determinants of health (SDOH).

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Holland & Knight Health Dose: May 14, 2024

HKLaw

Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector.

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Enhance Healthcare Efficiency With Top Payroll & HCM Services

Running a healthcare facility requires precision and care, not just for patients but also for your staff. Our guide, "A Buyer’s Guide to Payroll & HCM Services," helps healthcare providers choose the best provider. Efficient payroll management ensures timely, accurate payments, critical for maintaining staff morale and trust. Compliance support helps navigate complex healthcare regulations and avoid costly fines.

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4 Reasons to Get a DNP Degree

HIT Consultant

A DNP (Doctor of Nursing) degree is meant to help registered nurses with a BSN or MSN achieve the highest clinical nursing education level. The DNP degree shows that nurses have reached the peak of education. Graduating with a DNP degree comes with multiple rewards. Discussed below are four reasons to get a DNP degree. Leadership opportunities A DNP degree equips you with leadership skills that make you well-suited to take on advanced roles.

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Readers Write: Interoperability’s Last Mile – Universal Patient Consent and Access is Holding Us Back

HIStalk

Interoperability’s Last Mile – Universal Patient Consent and Access is.

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CLEW Medical Scores FDA Clearance for Next-Gen AI-Powered Patient Deterioration Prediction

HIT Consultant

What You Should Know: – CLEW Medical , a provider of AI-driven clinical surveillance and predictive analytics, has achieved a breakthrough with FDA 510(k) clearance for its second-generation AI models for predicting patient deterioration. – The FDA clearance builds upon their pioneering achievement of being the first FDA-cleared Class II medical device for this purpose in 2021.

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National Security Memorandum 20 and the Challenge of Operational End-Use Monitoring

The Rand Blog

The U.S. Department of Defense's internal efforts to address civilian harm due to U.S. military operations should be closely integrated with the goal of increasing accountability in arms transfer decisions. Making conditions associated with the transfer of U.S. arms more explicit is an important first step in being able to enforce them.

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Creating a Company Culture of Care: Integrating Mental Health, Wellbeing, and DEI in Benefits

Speaker: Sean Raible

Picture a workplace where physiological safety is not just an aim but a reality, driven by thoughtful employee benefits that prioritize mental health, wellbeing, and DEI. 🤔 ✨ Achieving this vision requires more than just occasional training sessions and employee assistance programs. Moving beyond the basics, this vision calls for a holistic approach that integrates these elements into your company culture as well as your HR and benefits strategy.